The Gables Retirement Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant people’s needs were not always met.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff did not always make sure people were at the centre of their care and treatment choices. For example, on the day of our inspection, lunch was served for everyone from 12:15pm. At 3:45pm, staff then began to support people to the dining room for their evening meal. We received feedback from some people that this gap was too short. We were assured that people were not restricted in any way as to when they had their meals, and the provider agreed to remind staff and people that the timings were not a set rule, just guidance for those who liked to structure their day, as stated in their service user guide.

Whilst some improvements were required to ensure care plans were accurate, we found guidance to support people’s emotional needs was person centred. For example, one listed different approach for staff to try if a person was feeling upset.

The provider had plans in place to seek detailed feedback from people and relatives around safety, activities, food, and care planning.

There were some shortfalls in how the provider understood the diverse health and care needs of people. Care records did not always provide accurate or sufficient information on people’s care and support needs. The provider’s systems for reviewing care plans and daily notes had failed to identify some of these shortfalls, and where they had identified care was not being provided in line with assessed needs, such as gaps in daily recording, effective action was not always taken to address this.

However, overall relatives were satisfied with the care provided and felt staff understood people’s needs.

The provider was working with the funding authority to ensure improvement in safety and stability in leadership before accepting further admissions. This demonstrated a commitment to delivering the right care for people using the service.

People’s communication needs were identified and assessed. Relevant policies were in place to support the service in meeting the Accessible Information Standard (AIS).

One person told us how they had been supported to understand their health condition.

We received some feedback that communication from management level needed improvement. For example, one relative told us, “The manager has changed but they didn’t tell us there was a change.” And “Communication with the owners is non-existent, for example they didn't tell us that the manager had changed.” The provider assured us that attempts were made to keep families informed of service changes, and plans were in place to reinforce transparency going forward with the newly appointed manager.

Learning from complaints, concerns or incidents was not always shared with staff. Despite some outcomes being for outcomes to be shared at staff meetings, staff meeting minutes did not always show these were discussed. This meant it was not clear how learning was incorporated into daily practice.

People and relatives were asked for their feedback through surveys. However, it was not always clear how the feedback was used to drive improvement.

There was a policy in place for complaints and information about how to raise a concern was visible in the service. Overall, people and relatives told us they knew how to raise a complaint if needed and felt satisfied with how issues were resolved. A relative told us, “If I have had issues, I have generally got them sorted.”

Staff knew how to support people to escalate concerns if needed.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

A relative told us that their loved one couldn’t always use the call bell due to their dexterity, but no action had been taken after this had been raised.

Staff used a pain scale tool to help monitor people’s levels of pain if they could not always verbally communicate this. This helped staff to administer pain medicine appropriately. Overall, this was utilised well, however during our inspection we observed 1 person who would have benefitted from this support tool, but it was not used. This meant they may have not had access to pain relief as needed.

However, systems were in place to escalate concerns and seek professional advice if needed. The health and well-being of all people using the service was regularly discussed at a multi-disciplinary meeting which meant care and treatment was always available.

Staff and leaders were trained in equality and diversity and supported by relevant policies to support people who were most likely to experience inequality in experience or outcomes. People had access to specialist equipment, such as walking aids or mattresses to support skin integrity.

People and relatives, we spoke with did not raise any concerns about discrimination.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. End of life care plans provided detail on what to do in the event someone was coming towards the end of their life, including funeral plan details. Staff worked well with healthcare professionals, and had received suitable training, to provide end of life care.